Moving Forward Together in Aboriginal Women's Health: - Theses ...

Moving Forward TogetherJanet KellyEven the seemingly non-complex tasks like a hearing program for Aboriginalchildren in schools became difficult. One staff member explained;We (the Aboriginal health team) planned a program of checking all theAboriginal children in the local schools over the term. At our first visit wefound huge health, financial, housing, social and safety issues for onefamily grouping involving 40 children and adults. Most of these peoplewere experiencing a range of physical, social and emotional issuesincluding violence and addictions. Some of the children requiredimmediate interventions including hospitalisation and mandatoryreporting (AH D7)The selective primary care prevention and health promotion program suddenlyground to halt as these clients filled the clinics and referrals for the next fewmonths. Staff found that using a selective primary care approach wasinadequate, and that the underlying issues spilled out regardless.When I asked Aboriginal health workers, a nurse and doctor in a meeting whatthey believed the most important aspects of Aboriginal women’s health were,they identified that loss and grief, social and financial concerns, familyviolence, being a carer for many families and community members, past andongoing trauma, social chaos, colonisation practices and discrimination wereaffecting the health and well-being of Aboriginal women’s that they wereseeing (AH M4). There was no manager at the Aboriginal Heath Service at thetime, and staff members dealt with the difficult complexities and as best theycould. Some staff members anguished over the mandatory reporting processbut there was no one for them to debrief them or talk about vicarious trauma 50 ,just each other.Co-researchers reflected that the holistic services and support that many clientswere seeking were getting harder to provide through community healthservices at Gilles Plains and elsewhere. Their experience was that thecommunity health system was aligning more closely with selective medical /clinical primary care than comprehensive primary health care, with decreasedsupport for community development models (Baum 2008; World Health50 Vicarious trauma is trauma experienced by those who work with people who have beentraumatised.224